Verrucous Keratosis – Everything You Need to Know
The medical term “Verrucous keratosis” sounds daunting indeed.
The good news is, the name sounds much worse than what the diagnosis actually means. According to the Medical Dictionary, the term “Verrucous” translates to mean “wart-like,” and the term “keratosis” means “a horny growth.”(1,2)
So the literal translation for this health issue is “a wart-like horny growth.”
Still, you probably have plenty of questions and you definitely want to learn more about what Verrucous keratosis is, what causes it, the major symptoms, how it is diagnosed and treated, and whether this health issue can be prevented.
This article will offer you the information you need to better understand your diagnosis.
What Is Verrucous Keratosis?
As explained in the Atlas of Head and Neck Pathology, keratin is the root word for the term “keratosis.”(3) This means that the matter that forms the growth is keratin, which is a somewhat waxy substance that grows to protect the epithelial (skin) cells from damage.
So a keratosis is basically an area on the skin that contains excess keratin.
Verrucous keratosis is a skin condition that is often confused with a very similar condition, seborrheic keratosis. Both conditions are benign and non-cancerous. When the wart-like growth, which is usually painless, develops more of a horny or serrated appearance, the growth is termed verrucous.
According to the National Institutes of Health (NIH), however, both conditions bear careful watching, as in certain rare cases they can progress to a pre-cancerous or cancerous stage.(4)
Their appearance can sometimes cause alarm, as the rough and sometimes uneven shape, surface or pigmentation of this health disorder can mimic the warning signs of a developing malignant (cancerous) growth. While it is always a good idea to biopsy such growths, finding a malignancy is relatively rare.
There are three main documented causes of this condition, as outlined by Real Health Vision: (5)
This health disorder is more common in industries where workers are regularly exposed to toxins or chemicals.
Examples include career radiologists, X-ray technicians, outdoor industries with significant daily ultraviolet exposure and researchers working with similar toxins or chemicals.
The exposure won’t manifest as Verrucous keratosis right away, but only after a prolonged period of exposure of decades or more. Often this condition will begin to show up when the individual is in their 40’s or 50’s and may be localized to the area(s) of persistent exposure.
The natural process of aging is also a well-known cause of Verrucous keratosis and its similar cousin, seborrheic keratosis. Here, the individual is usually over the age of 50 when warts begin to appear.
In some cases, age-related verrucous keratosis will only develop on the extremities (hands, feet) and may at a later date turn cancerous. In most cases, however, the growths are benign and may be found on the trunk, torso or near major joints such as elbows and knees.
Some individuals are more prone to developing this health issue early in life due to an inherited gene. Often, these individuals will start developing the growths as early as in their childhood.
The growths most typically appear on the extremities.
However, it is worth noting that Verrucous keratosis can also form on the forehead, in or around the mouth and even inside the body. This is more rare.
In most cases, as Inside the Clinic highlights, Verrucous keratosis is asymptomatic.(6) However, some patients report mild to intense itching associated with these growths.
As Verrucous carcinoma states, other common symptoms can include:(7)
» A bumpy circular or oval-appearing growth.
» A “greasy” appearance.
» Coloration is often in earth tones: black, brown, brown-black, tan.
» The growth looks as if it was “pasted” on and could be easily removed.
» Size per growth tends to fall between .39 inches (1 cm) and 1.18 inches (3 cm).
Where symptoms can become problematic is when the Verrucous keratosis growths are located in areas that receive a lot of friction, such as on the soles of the feet, on the hands or near the waistband.
This friction can cause the growths to become irritated, itchy or tender. Sometimes the exterior of the growths will even flake off.
As well, when the growths occur inside the mouth or body, such as on the larynx, they can sometimes produce additional symptoms relative to those areas.
Diagnosing Verrucous Keratosis
Because Verrucous keratosis does present with such similar symptoms to seborrheic keratosis, the diagnostic process must be approached with care.
There are also a number of additional skin conditions that can overlap with this condition in terms of symptoms and appearance, some of which are associated with auto-immune diseases, infection with HPV (human papilloma virus) or cancer.
Often dermatologists will diagnose this health disorder with a simple visual check, but to eliminate any ambiguity, the preferred diagnostic approach is always to excise (remove) the growth and do a medical biopsy to verify that it is benign.
Pathology Outlines offers an example of a common overlap with Verrucous vulgaris, a common skin growth often seen in patients who have been infected with the HPV virus. (8)
While these similar growths are also typically benign, it is important to do the additional testing to ensure that the patient does not have an underlying case of HPV that requires treatment.
The best diagnostic approach, therefore, is to follow these steps:
» Compile your family medical history to discover if any close relatives or immediate family also have a history of Verrucous keratosis or similar skin disorders.
» As best you can, write down your own medical history and any prior experiences with skin growths.
» Seek out care from a dermatologist, a professional specially trained for diseases of the skin.
» Have your practitioner examine the growth(s) and ask for a lab biopsy to confirm that they are benign and that they are not related to any other medical condition.
» Have your practitioner examine your body for additional growths or lesions, especially in places where you may have a hard time seeing them clearly on your own.
Once you have a definitive lab test-supported diagnosis in hand, you will have the information you need to decide whether to pursue treatment or not.
Treating Verrucous keratosis is optional. Some patients who are not experiencing any symptoms may decide not to do anything but watch the growths to see if there are any changes over time.
For patients who are experiencing itching or discomfort, topical creams or ointments can be prescribed.
Some patients prefer to have the growth(s) removed non-surgically. Liquid nitrogen is the most commonly prescribed method for non-surgically removing the growth(s). For larger growths or a larger number of growths, a surgical removal is also an option.
While Verrucous keratosis is not necessarily a condition that should cause excessive worry or concern, and it is relatively common in people over the age of 50, there are some preventative measures that can reduce or eliminate the incidence:
» Use sunscreen anytime you go out in the sun and wear protective clothing/hats.
» Do not itch, scratch or attempt to remove any growth(s) you find yourself.
» Learn stress management techniques (i.e. deep breathing, meditation, yoga, et al), since higher stress levels can compromise the body’s immune system function.
» Eat a healthy diet and get plenty of hydration and restful sleep.
» Take special precautions if you have a family history of Verrucous keratosis.
Conclusion: Next Steps
If you suspect that you or someone you love is suffering from Verrucous keratosis, it is important to seek out a diagnosis for your own peace of mind. Once you know your diagnosis, you can seek treatment to ease any stress you may be feeling.
Here are the steps to take to seek diagnosis and treatment:
• Compile your personal and family medical history, emphasizing any known past issues with skin disorders, including warts, lesions or growths.
• Make an appointment with a dermatologist.
• Have the exam and ask for a lab test to confirm that your growth(s) are benign.
• Have the dermatologist do a full physical exam to note any other growths.
• Talk with the dermatologist about the best options for treatment as needed.